Using Time-Driven Activity-Based Costing (TDABC) for Better Pricing of Different Chemotherapy Procedures in Medical Oncology

Abstract

Introduction: Adequate pricing of medical procedures is increasingly becoming a major issue in health insurance reforms and a tool for financial regulation and governance.

However, the price set for chemotherapy in the public sector (300 Moroccan dirhams set since 2006), without taking into account the real cost and the nature of the protocol administered, does not ensure fair reimbursement and negatively impacts the performance of oncology centers.

Objectives: This study aims to present in a practical way the main stages of application of the TDABC method on medical oncology and its capacity to measure the variation in the costs of the different procedures carried out. this will thus contribute to setting adequate prices and fair reimbursement for oncology centers.

Methods: We applied the TDABC method as a cost calculation approach that aims to ensure adequate pricing of the different chemotherapy procedures performed in medical oncology. The process maps were developed by direct observation of the activities carried out in one regional oncology center over a period of 3 months. The financial data on the costs of the different resource groups concern the expenses incurred during the year 2022.

Results: The result of the study shows the adaptability of the TDABC method to the context of medical oncology. To illustrate the approach to calculating the cost of activities and the total cost of a procedure, we present the example of the results associated with the anthracycline chemotherapy procedure. The costs of the other procedures require modifying the time parameters required to perform the tasks and the activity of each of the chemotherapy procedures.

Conclusions: The methodology developed can be exploited and generalized in several oncology centers to ensure adequate billing and equitable reimbursement by health insurance organizations in Morocco.

This study suggests and opens up prospects for exploring and applying the TDABC method in the management of oncology care in low- and middle-income countries. The approach adopted could be useful to managers and researchers in carrying out studies on the cost of health care in general, and in oncology in particular.